As governance structures and privacy and security measures are being developed, a health information exchange (HIE) must determine the technical infrastructure and procedure for delivering accurate, comprehensive, and secure data to users. How is data sent from one stakeholder to another, and in what format? What types of services are supported by the HIE, and how are they integrated into the infrastructure? There is no definitive answer or established best practice for the myriad of considerations for connecting technically to an HIE, since there are a number of factors that can affect or drive technical architecture and infrastructure. This module discusses a menu of approaches to these and other complex decisions in developing HIE infrastructure, connecting to existing HIEs, and technology considerations in supporting information exchange with providers and patients.